Sunday, June 3, 2007

Four Musketeers

Two years ago, I was diagnosed with prostate cancer. Not a very pleasant experience, those first few days and weeks, as I went from shock ("I'm too young!") to scrambling to learn about this unique-to-men form of cancer and decide how to deal with it.

Remarkably, maybe, two of my best friends stepped forward to offer advice and support; they too had had it. (I hadn't known.) And later on, another good friend received the same diagnosis, and I was able to offer some useful words to him.

But think of it: four men in their late 50's or early 60's (I was pretty much the link among the others, three of us being creative types and the fourth a lawyer--sort of the Three Musketeers and D'Artagnan--with each living in a different city) all getting the same diagnosis within a couple of years of each other. Does that reflect more cancer in the male population? Better diagnostic testing? An excess of zeal on the part of urologists?

Prostate cancer is pretty mysterious still--no one knows what causes it, or how to prevent it, or even what to do when it occurs. It can spread rapidly, ending a man's life in a few months, or it can take years, even decades, to grow and/or move out from the prostate into surrounding flesh or the bloodstream. Most, maybe all men actually contract it during their lives, but those with a slow-acting form can die at an advanced age from other causes before their prostate cancer ever reaches a dangerous state--and never know they had it.

So a diagnosed patient must decide, blindly really, whether to act quickly and decisively, or to take his time choosing a course of action, possibly even electing to "wait and see" for a few months or years. (That last is a plan followed often in Europe.)

No way I could wait, nor can I fathom how anyone might actually be casual, even blase, about a cancer in his (or her) body. Even though there are several newer treatments involving radiation these days that are, at least for the first few years, less intrusive and have fewer potential side effects, I chose the completely intrusive method of surgery to remove--meaning, cut out, albeit very carefully--my entire prostate.

Each of us, we Four Musketeers, made the same decision for radical surgery ("All for one, one for all!"), but acting independently. Now, months or years later, we can only shrug and state simply, "So far, so good"--and let me just touch wood saying that!

But the idea of surgery affected us in various ways. The lawyer already had had health problems for several years, and one more challenge, even prostate surgery, couldn't faze him. One guy never told anyone he had been diagnosed, just quietly went about his surgical experience, and only 'fessed up later; he seems ornery as ever. My operation was openly discussed and seems to have gone well, with no side effects of any significance. And the newest patient found afterward that his cancer was potentially virulent, but his surgery, we hope, came in the nick of time.

We four continue our complex and busy lives--yes, of course! that was the point of having surgery--perhaps now with a heightened sense of urgency. Yet only one of us knows that he really needed to act immediately; the rest only that ugly related surprises may still be waiting for one or all.